Marcus Aurélio Rabelo Lima Verde

A dual-purpose stent for the implant-supported prosthesis

Osseointegrated implants are a practical alternative to traditional prosthodontics; however, designing an implant-supported prosthesis with function and esthetics is a challenge. When the available bone or the location of vital structures is questionable, computed tomography (CT) is indispensable for diagnosis and treatment planning. This article describes a stent that implements the information from a CT scan and is then modified to guide the surgical placement of the implants.

Technique to restore unfavorably inclined implants

Unfavorable inclination of implants is a common problem that may compromise esthetics, phonetics, and function of the implant-supported fixed prosthesis. Several methods have been reported to compensate for malaligned implants; however, most techniques are complicated and expensive. A technique that combines a custom abutment from a hexed UCLA-type plastic burn-out pattern and a manually threaded setscrew hole is a relatively inexpensive and uncomplicated approach to eliminate problems caused by unfavorable implant inclination. This article describes the procedures for fabrication of an implant-supported fixed prosthesis with the use of this technique.

A fixed-detachable implant-supported prosthesis retained with precision attachments

The implant-supported, maxillary anterior, fixed-detachable prosthesis is often fabricated with a gingival flange to enhance esthetics and phonetics. However, only the dentist can remove the prosthesis, and the esthetic labial flange invariably impedes patient access for cleaning. A two-piece, fixed-detachable prosthesis that incorporates a substructure retained with conventional set screws and a superstructure retained with precision attachments has been developed. The substructure is contoured to facilitate patient access for oral hygiene because it will be covered by the superstructure and neither esthetics nor phonetics is a concern. The superstructure is easily removed by the patient for routine cleaning and can be designed for favorable esthetics and phonetics. This article reviews and describes the procedures for fabrication of this precision attachment-retained, implant-supported prosthesis.

Evaluation of soldered connectors of two base metal ceramic alloys

Soldered connectors for two base metal ceramic alloys (nickel-chromium and cobalt-chromium) were compared by use of four different techniques: (1) infrared preceramic soldering, (2) gas and oxygen preceramic soldering, (3) porcelain furnace postsoldering under vacuum, and (4) porcelain furnace postsoldering without vacuum. A control group was established with solid cast specimens of each alloy. No statistically significant difference was noted between infrared and torch preceramic soldering techniques for either of the two alloys. However, the joints postsoldered under vacuum were significantly superior to postsoldered connectors without vacuum (p < 0.0001). No significant differences were observed among techniques 1, 2, and 3, although the three groups were substantially superior to technique 4 for both alloys (p = 0.05). The control group for both alloys was appreciably stronger than the soldered groups (p < 0.0001), and the nickel-chromium samples within the control group were significantly stronger than the Co-Cr samples.

Oral rehabilitation of severely worn dentition using an overlay for immediate re-establishment of occlusal vertical dimension

The aim of this study was to describe the treatment used in an elderly patient presenting with bruxism and dental erosion, with good gingival health and bone support, but with decreased occlusal vertical dimension (OVD). The oral rehabilitation of elderly patients presenting with bruxism in association with tooth erosion has been a great challenge for dentists. The loss of OVD, the presence of occlusal instability and the absence of an effective anterior guide due excessive dental wear, can damage stomatognathic system (SS) biology, the function and the aesthetics. In the first treatment stage, an overlay removable partial denture (ORPD) was fabricated for the immediate re-establishment of function and aesthetics. After a 2-month follow up, with the patient presenting no symptoms, a second rehabilitation stage was accomplished, with fixed and removable prostheses. Oral rehabilitation with an ORPD was able to re-establish the SS biology, but a correct diagnosis and treatment plan are essential for success. The ORPD is a non-invasive and reversible restoring modality for general dentists that allow the re-establishment of the patients immediate aesthetics and function at low cost.

The role of polymerization cycle and post-pressing time on tooth movement in complete dentures

This study analyzed the influence of polymerization cycle and post-pressing time on tooth movement in complete dentures. Forty maxillary complete dentures were fabricated and randomly assigned to 8 groups (n = 5); the polymerization cycle (conventional long cycle in water bath, fast cycle in boiling water, and by microwave energy) and the post-pressing time (immediate and 6 hours) were varied. Metal reference pins were placed on the incisal border of the central incisors (RI and LI), on the buccal cusp of the first premolars (RP and LP), and on the mesiobuccal cusp of the second molars (RM and LM). Two transverse and 2 anteroposterior distances were measured with a linear optical microscope (Olympus Optical Co., Tokyo, Japan) with an accuracy of .0005 mm, before and after processing the complete dentures. The data collected were submitted to analysis of variance (ANOVA) and the Tukey Test at a significance level of 5%. When Clássico, a conventional heat-polymerizable acrylic resin, was polymerized by microwave energy, tooth movement was statistically significant for 2 distances, with the highest value being observed for the 6-hour post-pressing time. Onda-Cryl microwave acrylic resin processed by microwave energy presented the lowest tooth movement for 2 distances, considering the 6-hour post-pressing time. QC-20 acrylic resin presented no statistically significant change considering both post-pressing times in each distance evaluated. Tooth movement showed an asymmetric behavior, so the mastering of the processing method is essential to the precise execution of all laboratory steps, irrespective of the polymerization cycle and post-pressing time used.

Single-stage osseointegrated implants for nasal prosthodontic rehabilitation: A clinical report

Malignant tumors in the nasal region may be treated by means of invasive surgical procedures, with large facial losses. Nasal prostheses, retained by osseointegrated facial implants, instead of plastic surgery, will, in most patients, offer good biomechanical and cosmetic results. This clinical report describes the prosthetic rehabilitation of a patient with nasal cancer who had the entire nasal vestibule removed in a single-stage surgical procedure in order to shorten the rehabilitation time. The nasal prosthesis was built on a 3-magnet bar and was made of platinum silicone with intrinsic pigmentation, thereby restoring the patients appearance and self-esteem. The authors concluded that single-stage implants may reduce the rehabilitation time to as little as 1 month, and the correct use of materials and techniques may significantly improve the nasal prosthesis.

Surgical and prosthetic considerations to rehabilitate an ocular defect using extraoral implants: a clinical report.

This clinical report shows the use of extraoral implants to rehabilitate an ocular defect, focusing the surgical and prosthetic procedures. Using local anesthesia and a surgical template obtained from the diagnostic wax ocular pattern, two cylinder dental implants were strategically placed in the lateral aspect of the right infraorbital region. Four months later, an acrylic framework including two spherical magnets was made using plastic UCLA abutments. After casting laboratory steps, a customized silicon prosthetic appliance was fabricated from the diagnostic wax ocular pattern and attached to the Co-Cr framework, observing its profile and seating aspects. The patient was satisfied with the treatment result, due to the retention, esthetics, and adhesive-free method to anchor his ocular prostheses.

Economical slotted screwdriver made from old dental instrument for implant prosthodontics

Implant dentistry has brought many possibilities for the restoration of edentulous and partially edentulous patients; however, the high cost of dental implant fixtures and components is a major concern. Contemporary infection control practices mandate heat sterilization of reusable dental instruments that have been placed in the oral cavity.l Therefore, the dentist with a busy implant practice must stock numerous duplicate instruments at considerable expense. Slotted screwdrivers are very often used in implant procedures, and the retail cost of an implant